LEGISLATION TO GOVERN MIDWIFERY PRACTICE
In order to protect both the public and midwives themselves, it is important to regulate and license midwives, and the programmes and establishments used in their training. It is also essential not to give the license or accreditation ‘for life’. Hence, a set of accreditation requirements must be instituted for the accreditation (and re-accreditation) for fixed periods of time. For the individual midwife this should be based on her/his ability to demonstrate that she/he has the required skills and abilities to practise the profession safely according to the national requirements.
Midwifery legislation is the part of a nation's laws that relate to the profession and practice of midwifery. Midwifery regulation is the set of criteria and processes arising from the legislation that identifies who is a midwife and who is not, and describes the scope of midwifery practice.
Registration, sometimes called licensure, is the legal right to practise and to use the title of midwife. Regardless of the type of mechanism used, it is important to ensure that the process is and continues to be transparent, fair and robust; it should therefore be evaluated periodically. There is also a need for mechanisms that enable previously practising midwives to return to service after a prolonged absence.
STATEMENT OF BELIEF
The ICM believes that there should be appropriate legislation relating to the practice of midwives in all countries. ICM also believes that professional associations should work with governments to find ways to maximise service delivery capacities in countries. This will imply the establishment of good human resource management policies and regulations, as well as the involvement of professionals in determining service standards for the provision of high-quality care at all levels in both the private and public sectors.
Legislation which is enacted to govern the practice of midwives should:
• enable midwives to practise freely in any setting
• ensure the profession is governed by midwives
• support the midwife in the use of life-saving knowledge and skills in a variety of settings in countries where there is no ready access to medical support
• enable midwives to have access to ongoing education
• require regular renewal of right to practise
• adopt a ‘Definition of the Midwife’ congruent with the ICM definition, appropriate to the country within the legislation
• provide for consumer representation on the regulatory body
• recognise that all women have a right to be attended by a competent midwife
• allow for the midwife to practise in her own right
• recognise the importance of separate midwifery regulation and legislation which supports and enhances the work of midwives in improving maternal, child and public health
• provide for entry to the profession that is based on competencies and standards and which makes no distinction between routes of entry
• provide the mechanism for a regulatory body that is governed by midwives with the aim of protecting the public
• provide for regular review of the legislation to ensure it remains appropriate and not outdated, as midwifery education and practice and the health services advance
• encourage the use of peer review and analysis of perinatal, maternal and newborn outcomes in the legislative review process
• provide for transition education programmes in the adoption of new legislation requiring increased levels of competency of the midwife.
GUIDING STATEMENT TO MEMBER ASSOCIATIONS:
Member Associations are urged to use this statement to achieve legislation
which will be appropriate for the practice of midwifery in their country.
RELATED ICM DOCUMENTS
• ICM position statement. Framework for midwifery legislation and
regulation. ICM, 2002.
OTHER RELEVANT DOCUMENTS
• Mother Baby Package: Implementing Safe Motherhood in Countries. Geneva,
Switzerland: WHO, 1994.
• ICM. Definition of the Midwife. ICM, 2005.
• Bryce GK. Overview paper presented to Workshop on Legislation, May 1983
Vancouver ICM Congress (Unpublished).
• The Safe Motherhood Action Agenda. Priorities for the next decade. Report
on the Safe Motherhood Technical Consultation October 1997 Sri Lanka, Family
Adopted at Glasgow Council meeting, 2008
Due for next review 2014
[The International Confederation of Midwives (ICM) supports and advises associations of midwives. The ICM is an accredited non-governmental organisation and works closely with the WHO, UNFPA, UNICEF and other organisations worldwide to achieve common goals in the care of mothers and children.]